NPI Code Details Logo

NPI 1184729469

NPI 1184729469 : STEVEN GREENLEAF CRNA : JACKSONVILLE, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1184729469
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    STEVEN GREENLEAF CRNA
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/13/2006
-----------------------------------------------------
    Last Update Date     |    09/17/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    4500 SAN PABLO RD S 
-----------------------------------------------------
    City                 |    JACKSONVILLE
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    32224-1865
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    904-953-2000
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    744 W MICHIGAN AVE 
-----------------------------------------------------
    City                 |    JACKSON
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    49201-1900
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    517-787-6440
-----------------------------------------------------
    Fax                  |    517-787-4146
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    367500000X
-----------------------------------------------------
    Taxonomy Name        |    Certified Registered Nurse Anesthetist
-----------------------------------------------------
    License Number       |    APRN11036257
-----------------------------------------------------
    License Number State |    FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    367500000X
-----------------------------------------------------
    Taxonomy Name        |    Certified Registered Nurse Anesthetist
-----------------------------------------------------
    License Number       |    26NR10436300
-----------------------------------------------------
    License Number State |    NJ
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.